| Theme |
The Newest Strategies for Severe Ulcerative Colitis |
| Title |
Recent Surgical Treatment for Severe Colitis |
| Author |
Tsuneo Fukushima |
Yokohama Municipal Citizen's Hospital |
| Author |
Kazutaka Koganei |
Yokohama Municipal Citizen's Hospital |
| Author |
Fumihiko Kitoh |
Yokohama Municipal Citizen's Hospital |
| Author |
Mitsuyoshi Ota |
Yokohama Municipal Citizen's Hospital |
| Author |
Kazuhisa Takeda |
Yokohama Municipal Citizen's Hospital |
| Author |
Hirochika Makino |
Yokohama Municipal Citizen's Hospital |
| Author |
Kanako Hoshi |
Yokohama Municipal Citizen's Hospital |
| [ Summary ] |
Severe or fulminant colitis often complicates toxic megacolon, perforation or massive bleeding and must be recognized as lethal conditions, unless rapid and appropriate treatment is conducted. Mortality was reported to be high, especially with the complication of perforation. The aim of surgical treatments for severe or fulminant colitis is to save lives and intestinal anastomosis is not indicated. Total colectomy, ileostomy and treatment for mucus fistula has been performed for severe colitis at the majority of institutions. Recently, the use of restorative proctocolectomy has been challenged for selected cases of severe colitis, not complicated by toxic megacolon. At present, indications for one stage pouch operations for severe colitis are limited and surgeons should judge their use conservatively. |